Evaluation of the impact of restructuring wound management practices in a community care provider in Niagara, Canada.

The burden of chronic wounds is substantial, and this burden is set to increase as the population ages. The challenge for community health services is significant. Wound care is labour intensive, and demand for services is set to increase at a time when the availability of nursing resources is likely to be severely limited. In March 2005, the Niagara community health care provider implemented a radical reorganisation of wound management practices designed to ensure that available resources, particularly nurse time, were being used in the most efficient way. An evaluation of the impact of the reorganisation has shown improvements in clinical practice and better patient outcomes. The use of traditional wound care products reduced from 75% in 2005 to 20% in 2007 in line with best practice recommendations, and frequency of daily dressing changes reduced from 48% in 2005 to 15% in 2007. In a comparison of patients treated in 2005 and 2006, average time to healing was 51.5 weeks in 2005 compared with 20.9 weeks in 2006. Total treatment cost was lower in 2006 by $10,700 (75%) per patient. Overall, improvements in wound management practice led to a net saving of $3.8 million in the Niagara wound care budget.